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More than 83,000 people have run from their homes, funneling into some 45 camps and settlements to escape fighting in Myanmar's northeastern Kachin State. But over half the displaced are still unreachable by international aid workers because they are located in rebel-controlled areas.

"We had to dig trenches around our home because the Burmese army [was] using fighter jets to attack KIA [Kachin Independence Army] soldiers near our village," recalled 65-year-old Pokin Kon Dok. She fled her home near Laja Yang Village last December, carrying only her one-month-old granddaughter, after government forces launched an offensive against ethnic Kachin troops near the border town of Laiza.

Now, Polkin and her extended family share a single bamboo hut with six other recent arrivals in Je Yang, a camp in Laiza that currently houses an estimated 6,000 people. The area, near the site of a main rebel camp, is inaccessible by international aid workers.

Health fallout

In other parts of the camp, stone workers and labourers break large rocks to re-enforce dirt roads and pathways leading into the area. Others stack bricks into baskets on their backs, preparing to build latrines.

"The current ratio is one toilet for 60 persons, but that is not enough, so now we are building an additional 300 toilets in the whole of Je Yang camp," said camp supervisor Brang Shaw.

Emergency aid standards require a minimum of one latrine per 20 adults or 10 children. Local health workers have reported treating a regular stream of internally displaced persons (IDPs) with stomach ailments caused by diarrhoea and parasites.

In southern Kachin State, a network of eight local aid groups, including Wun Pawng Ninghtoi (WPN), is providing food, clothing, shelter and medicine to nearly 10,000 IDPs in six camps.

The protracted conflict has taken a toll on diets and nutrition, say aid workers, who have not conducted any formal studies on malnutrition rates among the displaced.

WPN head Mary Tawm said that while basic foods like potatoes and rice are distributed, vegetables and meats are sparse.

Lack of access to clean water and sanitation has proved fatal.

"In January, seven children drank water from a mountain stream that was polluted with pesticides from a nearby sugar cane plantation, and one of the girls died. Several of them had to be transferred to a Chinese hospital for emergency treatment," said Tawm.

And while the local hospital in Mai Jai Yang can treat routine health problems, more complicated cases

must be transferred across the border into China. Soldiers with heavy casualties have reportedly been transferred there as well.

"We needed to spend US$3,000 for 17 referred patients to the China side in January and another 20 patients in February, basically to save people's lives, but we don't have enough funding so we are asking our community for help," she said.

International aid still blocked

"The international NGOs can get into the government-controlled area very easily, but it is difficult to get to the China border where most of the IDP camps are located and in need of the most [assistance]," explained Hkalam Samson, head of local NGO Kachin Baptist Convention.

Since the start of the conflict, most of the food and medical supplies in KIA-controlled areas have been donated by local religious groups, and the Kachin Independence Organization, KIA's political wing.

Deemed unsafe by the government, rebel-controlled areas have been largely off-limits to international aid groups since the collapse of a 17-year peace agreement in June 2011. Only a small number of UN convoys have reached KIA-controlled territory since then, the most recent one being in mid-February this year.

"Several of the camps are overcrowded because nine camps on the Chinese side were shut down last summer by Chinese authorities, and the refugees were forced back onto the Kachin side of the border," Samson added.

On the Burmese side of the border, the population of Lana Zup Ja camp has more than doubled from last year's 1,138 to 2,689 at the end of March, according to WPN.

Given such crowded camps, UN Refugee Agency (UNHCR) is concerned about potential abuses and the lack of international monitors in KIA-controlled areas. "When we build shelters through our [local] partners - who do have access - we cannot monitor their progress. We are also unable to conduct capacity building such as camp management or protection training," said Anna Little, a UNHCR spokesperson in Myanmar.

Since fighting resumed in June 2011, 12 peace talks have been held between the government and rebels, including five in China.

Meanwhile, international groups continue calling for unfettered access to all of Kachin's IDPs.

The KIA has been fighting for greater autonomy from Myanmar's central government for the past six decades.